The effect of hypertrophied tonsils on the velopharyngeal function in children with normal palate

Publication date: Available online 16 January 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Mosaad Abdel-Aziz, Mahmoud El-Fouly, Ahmed Nassar, Ahmed Kamel, Ahmed Kamel

Abstract

Objective

Tonsillar hypertrophy may affect velopharyngeal closure and speech resonance. The aim of this study was to assess the impact of hypertrophied tonsils on velopharyngeal function in children with normal palate and to measure the effect of tonsillectomy on velopharyngeal closure and speech resonance.

Methods

Eighty seven children with hypertrophied tonsils and normal palate were subjected to tonsillectomy for indications other than speech problems. Preoperative and postoperative evaluation of velopharyngeal function was performed. Auditory perceptual assessment of speech (APA) and nasometric assessment of nasalance was measured, and velopharyngeal closure was evaluated by flexible nasopharyngoscopy.

Results

Thirteen patients were excluded from the study because of associated adenoid hypertrophy. The mean baseline of APA scores showed insignificant changes postoperatively. However, significant postoperative changes of nasometric parameters were detected, and the overall postoperative nasalance score was improved for nasal and oral sentences. Also, improvement of velopharyngeal closure was observed postoperatively with accession of palatal mobility and significant increase in coronal closure pattern.

Conclusion

hypertrophied tonsils may impair velopharyngeal function in children with normal palate by hindering palatal elevation. Tonsillectomy is a beneficial procedure for such patients as it can improve the velopharyngeal closure and speech resonance.

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